1. Effective HIV & SRH Responses Among Sex Workers and other Key Populations
Module 1: National Data

2. Objectives Review Country HIV status
Know where we are in regards to SRH health needs for KAPs

3. Bangladesh Situation
First HIV case in the country was detected in 1989.
Bangladesh still a low prevalent country in the region:* Prevalence rate - <0.1%
Prevalence rate among key populations – <1%
Concentrated epidemic (5.3%) among people who inject drugs (PWID) in Dhaka
0.1% of young people aged 15–24 who are living with HIV
Estimated number of HIV infected people is 9,000
* Source: 9th round National HIV Serological Surveillance 2011

4. Bangladesh Situation by New Cases of HIV and AIDS Related Deaths
Total New Cases in 2014
New HIV
433
AIDS Deaths 91
Cumulative Cases
HIV
3,674
Total AIDS Deaths
563

5. Estimated and Reported Cumulative Number of People Living with HIV, 1989-2014

6. Gender Distribution of New Cases: 2014
Number
Male
298
Female
131
Transgender 4
Total
433

7. Age Distribution of New Cases: 2014
No of cases
0-5 years 15
6-9 years 8
10-18 years 5
19-24 years 42
years
323
50> 40
Grand Total
433

8. HIV prevalence over the rounds of HIV surveillance
Source: NASP, 2011

9. HIV prevalence among female sex workers, 2011
Street, Female sex workers
Hotel, Female sex workers
Casual, Female sex workers
Residence,
FSW
Combined residence and hotel, female sex workers

10. Prevalence of HIV and active syphilis over time: Dhaka
P<0.05 for MSW and hijra
Active syphilis
Source: NASP, Surveillance reports & GF RCC project icddr,b, 2010, 2013

11. Prevalence of active syphilis among female sex workers, 2011

12. Bangladesh’s approach to the HIV epidemic
Target key populations –
people who inject drugs (PWID),
female sex workers,
males who sex with males (MSM) including male sex workers (MSW)
transgendered people (hijra)
PLHIV
Other population groups –
migrants
Young people

13. HIV targeted interventions in Bangladesh – landmark events
Targeted interventions among hijra started
Further scaling up in all groups including MSM and hijra
1st case of HIV
1989
2000
Scaling up in all groups except MSM & hijra
Targeted interventions among FSW, PWID and MSM started

14. Drug Use and HIV Infection
Wives and girlfriends of
clients
Wives and girlfriends of
Substance users
Clients of FSWs
Substance Users
Female Sex Workers
IDUs
Husbands and
boyfriends of FSWs
HIV
RISK RINGS

15. HCV prevalence among PWID, 2011
Note: Combined PWID/HS refers to the combined group of PWID and heroin smokers.
Numbers in brackets refer to the total numbers of PWUD sampled in each site
Source: NASP, 2011

16. Active syphilis prevalence among PWID, heroin smokers and combined PWID & heroin smokers, 2011
Note: Combined PWID/HS refers to the combined group of PWID and heroin smokers.
Numbers in brackets refer to the total numbers of drug users sampled in each city
Source: NASP, 2011

17. Reaching with HIV Prevention Intervention
Reached with HIV Prevention Programme
7.5 % of female sex workers
65.9% of male sex-workers
70.7% of transgendered sex workers
29.2% of MSM

18. Received an HIV test in the past 12 months and know their results
4.1 % of female sex workers
39.4% of male sex-workers
41.1% of transgendered sex workers
15.9% of MSM who have
0.27% of HIV testing coverage at ANC

19. Where about Condom Use?
Percentage of sex workers reporting the use of a condom with their most recent client
66.8 % of female sex workers
58.8% of male sex-workers
45.3% of transgendered sex workers
49.6% of MSM who have

20. Where we are? Evidence from A study in six countries in the region:
33% of women living with HIV in Bangladesh reported their most recent pregnancy was unwanted.
FSW in Bangladesh found that 60% had an unmet need for family planning compared to 16.8% of married women ages 15–49 (survey)

21. Service delivery model: Implemented by NGOs
Field based outreach activities
Community development & mobilization
Education and awareness
BCC session & material distribution
Condom, lubricant/needles and syringes distribution
On-site educational sessions
Referrals
DIC based activities (Drop-in-services)
Social gathering, rest & recreation
Group education session
Counseling: psycho-sexual & psycho-social
Audio-visual learning
Condom and lubricant demo. & distribution
Clinical services at DIC
STI syndromic management & treatment, counseling
abscess management
General health treatment
VCT
Referral - VCT, care & support, complicated STI &
other health complications, drug detoxification
Capacity building
Peer education training
Life skill training
Vocational training /income generation
Local level advocacy
Project/DIC Facilitation Team to sensitize lawyers, journalists,
Sensitization meeting with religious leaders, Health Service
Providers & local elite
Sensitization meeting with law enforcement agency
Legal support through referral linkage